World Journal of
Pharmaceutical and Life Sciences

TORSADOGENIC RISK ASSOCIATED WITH PROKINETIC MEDICATION: A CASE REPORT OF QT PROLONGATION

Mr. Vetriselvan V., Dr. M. K. Sundar Sri, Dr. M. Kalaiarasan*

ABSTRACT

Background: Drug-induced QT interval prolongation is a clinically significant adverse drug reaction that can predispose patients to Torsades de Pointes, a potentially fatal ventricular arrhythmia. Prokinetic agents, although widely used for gastrointestinal motility disorders, have been implicated in cardiac repolarization abnormalities. Case Presentation: We report a case of a 58-year-old female with type 2 diabetes mellitus and hypertension who developed palpitations, dizziness, and near-syncope following initiation of domperidone for diabetic gastroparesis. Electrocardiography revealed marked QTc prolongation of 528 ms. Laboratory investigations, including serum electrolytes and cardiac biomarkers, were within normal limits, and echocardiography showed no structural heart disease. A diagnosis of domperidone-induced QT prolongation was made. The drug was immediately discontinued, and the patient was managed with cardiac monitoring and supportive care, including electrolyte optimization. Serial ECGs demonstrated progressive normalization of the QT interval over one week. Conclusion: Domperidone can cause significant QT prolongation leading to torsadogenic risk. Early detection, prompt drug withdrawal, ECG monitoring, and supportive care are essential to prevent life-threatening ventricular arrhythmias and complications.

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